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Chest pain in the absence of obstructive coronary artery disease

Chest pain in the absence of obstructive coronary artery disease

Authors :
J. Wouter Jukema
Laurien E Zijlstra
Hubert W. Vliegen
Marianne Bootsma
A.V.G. Bruschke
Martin J. Schalij
Source :
International Journal of Cardiology. 280:19-28
Publication Year :
2019
Publisher :
Elsevier BV, 2019.

Abstract

Patients presenting with chest pain suggestive of coronary artery disease (CAD) who at coronary arteriography appear to be free of obstructive disease have presented a diagnostic and therapeutic challenge since the 1970's. Studies in female patient populations have suggested that this is predominantly a women's syndrome usually caused by microvascular endothelial dependent and independent dysfunction. A critical review of the literature focusing on studies including both women and men revealed that apart from a higher incidence of this syndrome in women there are no clinical relevant differences between both sexes. In women a lower coronary flow reserve has been reported but this appears to be mainly due to a higher basal flow. Important questions with regard to the clinical implications of microvascular dysfunction have yet to be resolved in studies involving women as well as men in which a distinction is made between patients with normal coronary arteries and those with nonobstructive disease.

Details

ISSN :
01675273
Volume :
280
Database :
OpenAIRE
Journal :
International Journal of Cardiology
Accession number :
edsair.doi...........428f738696080ecfd4f8e2421cb0532a
Full Text :
https://doi.org/10.1016/j.ijcard.2018.09.103